Tensions in the epistemic domain and claims of no-knowledge: A study of Swedish medical interaction

•This article analyzes the Swedish epistemic disclaimer jag vet inte in patient responses.•The responses problematize the presupposed access or rights to knowledge.•By claiming no knowledge, the speaker can initiate a shift in epistemic posture.•The shift is toward a more independent, personally accurate formulation of knowledge.•This formulation of knowledge contrasts with the professional party's assumptions.

This article analyzes the halts in sequential progressivity that are caused by claims of no-knowledge in Swedish medical interaction. The focus is on responsive turns and turn-constructional units that are prefaced by the epistemic disclaimer jag vet inte 'I don't know'. We argue that this use of epistemic disclaimers does not primarily display the speaker's lack of knowledge, but that their presence signals interactional problems that are contingent on epistemic asymmetries between the participants. Patient replies that contain an epistemic disclaimer are nonconforming responses and they therefore resist something about the question: the presupposed access to knowledge or the rights to knowledge. The present analysis demonstrates that epistemic tensions, especially in lay-professional interaction, are handled by the lay party using epistemic disclaimers. These can initiate a shift in epistemic posture toward a more independent, more personally accurate formulation of knowledge that somehow contrasts with the professional party's assumptions.